Issues facing pharmacy leaders in 2015: suggestions for pharmacy strategic planning

How a more detailed understanding of culture is needed before successful educational change can be made

INTRODUCTION

The profession of pharmacy is being afforded many important opportunities, and continues to face many challenges. To successfully address these issues schools and colleges of pharmacy must have a complete understanding of their current context, which includes culture. However, little of the work on culture in pharmacy education specifically defines what these cultures are, and equally importantly how this understanding of culture can be used to make changes, improve student learning, and ultimately develop pharmacists better prepared to improve patient outcomes.

PERSPECTIVE

Organizational culture has been defined in a multitude of ways in the literature. Martin's three-perspectives approach, which combines integrated, differentiated, and fragmented understandings, offers one way to approach defining culture and leveraging that definition of change. Furthermore, the organizational culture profile (OCP), is one tool that can be used to identify and differentiate between Martin's three perspectives.

IMPLICATIONS

Culture plays an important role in academic pharmacy, but before it can reach its highest potential in improving student outcomes, and faculty experience, it must be completely understood. Martin's approach and the OCP offer one way to achieve this objective.

Expanding care through a layered learning practice model

PURPOSE

The outcomes of a patient-centered layered learning practice model (LLPM) in which the clinical specialist acted as the attending pharmacist and managed a pharmacy team to provide direct patient care were evaluated.

METHODS

Two 30-day evaluations were conducted on the acute care malignant hematology and medical oncology services of the University of North Carolina Medical Center in 2011. The primary objective of this study was to design an LLPM that used a team to expand the pharmacist care services offered. The primary outcome was the frequency of pharmacy team encounters at discharge (medication reconciliation and counseling), termed the discharge capture rate.

RESULTS

During the study months, 42 and 78 malignant hematology and medical oncology patients were eligible for study inclusion, respectively. The overall discharge capture rate was 51%. Sixty-one patients received discharge medication reconciliation services during patient counseling. Patients included in the malignant hematology group received a mean of 11 prescriptions at discharge, compared with 9.83 in the medical oncology group. Means of 1.26 and 2.1 medication-related problems per patient were identified in the malignant hematology and medical oncology studies, respectively, during discharge medication reconciliation. The overall mean face time spent per patient was 21.3 minutes.

CONCLUSION

Patients in malignant hematology and medical oncology services were counseled and provided discharge medication reconciliation by a pharmacy student or resident whose activities were managed and reviewed by an attending pharmacist using an LLPM, resulting in an improvement in all clinical outcomes and measures.

A Study of Layered Learning in Oncology

Objective. To explore use of pharmacy learners as a means to expand pharmacy services in a layered learning practice model (LLPM), to examine whether an LLPM environment precludes achievement of knowledge-based learning objectives, and to explore learner perception of the experience. Design. An acute care oncology pharmacy practice experience was redesigned to support the LLPM. Specifically, the redesign focused on micro discussion, standardized feedback (eg, rubrics), and cooperative learning to enhance educational gain through performing clinical activities. Assessment. Posttest scores evaluating knowledge-based learning objectives increased in mean percentage compared to pretest values. Learners viewed the newly designed practice experience positively with respect to perceived knowledge attainment, improved clinical time management skills, contributions to patient care, and development of clinical and self-management skills. A fifth theme among students, comfort with learning, was also noted. Conclusion. Layered learning in an oncology practice experience was well-received by pharmacy learners. Data suggest a practice experience in the LLPM environment does not preclude achieving knowledge-based learning objectives and supports further studies of the LLPM.